PROJECT SUMMARY/ABSTRACT This proposal is to continue longitudinal follow-up of lupus cases and controls in the population-based Michigan Lupus Epidemiology & Surveillance (MILES) Program Cohort and Biobank. The overarching goal is to prospectively collect data and biospecimens that will allow for comprehensive investigations of risk factors related to lupus and disease progression, as well as underlying disparities. We are currently in a third wave of cohort study visits. Detailed data collection encompasses measures related to four core content areas: natural history, treatment, healthcare access and disparities. The state-of-the-art biobank includes whole blood, serum, plasma, DNA/RNA (from lymphocyte subsets), urine, hair, and toenail clippings. Biobank specimens are processed and stored in appropriate conditions to provide the capacity to perform assays including contemporary immunoassays, biomarkers of disease and exposures, genotyping, and DNA methylation of relevant lymphocyte subsets. Major thematic areas that the MILES Cohort & Biobank is designed to support include environmental and nutritional epidemiology, epigenetics, and health services research. The MILES Cohort will thus serve as a robust platform for ongoing and future research investigations that are relevant to the full spectrum of lupus and its complications.